Figure 4.

Effect of prolonged PPI treatment in ZES patients on body iron stores/levels (A) or serum vitamin B₁₂ and folate levels in two NIH (B). In (A), data from 109 ZES patients treated with antisecretory drugs for a mean of 10.2 years are shown (81% PPIs for 6 years, 8% histamine H₂ receptor antagonist, 10% cured, off all drugs). Results are shown for patients with or without advanced basal acid hyposecretion on the antisecretory drug. Normal values are shown by the dotted lines and means ± SEM are also shown for each group. (B) shows serum vitamin B₁₂ and folate levels in 108 ZES patients correlated with time of omeprazole treatment. The serum vitamin B₁₂ levels inversely correlated with the time of omeprazole treatment, whereas there was no effect on the serum folate levels. Figures are drawn from data in [27,253]. These data showed that prolonged chronic treatment in ZES patients did not affect serum iron levels or iron body stores, however there was a significant decrease in serum vitamin B₁₂ levels correlating with PPI treatment duration, but not serum folate levels.